Archives of Suicide Research最新文献

Objective: Deficits in decision-making (DM) are a significant risk factor for suicidal behaviors. However, specific patterns of DM aspects have rarely been examined. This study examined the profiles of DM and their relationship with suicide ideation and attempts.

Methods: A total of 175 young adults participated in an online survey and the Cambridge Gambling Task between October and November 2021.

Results: Based on the latent profile analysis with four aspects of DM-risk DM, risk adjustment, DM speed, and delay-discounting-as indicators, three profiles were identified: (1) no deficit class, (2) high risk DM class, and (3) slow DM speed class. Higher use of an avoidant and dependent DM styles was associated with a greater likelihood of being in the slow DM speed class. Younger age and psychache was associated with a greater likelihood of being in the high risk DM class. The rates of lifetime suicide ideation (i.e., wish for death, suicide intent, and suicide plan) and lifetime suicide attempt were higher in the high risk DM class than in the no deficit class. The rate of lifetime wish for death was higher in the slow DM speed class than in the no deficit class.

Conclusions: Suicide prevention may benefit from addressing DM, which is characterized by high risk and slow speed.

Objective: Female labor-force participation (FLFP) has been theorized as contributing to higher suicide rates, including among women. Evidence on this relationship, however, has been mixed. This study explored the association between FLFP and suicide in an understudied context, Taiwan, and across 40-years.

Methods: Annual national labor-participation rates for women ages 25-64, and female and male suicide-rates, for 1980-2020, were obtained from Taiwan's Department of Statistics. The associations between FLFP rates and sex/age-stratified suicide-rates, and between FLFP rates and male-to-female suicide-rates ratios were assessed via time-series regression-analyses, accounting for autoregressive effects.

Results: Higher FLFP rates were associated with lower female suicide-rates (ß = -0.06, 95% CI (Credibility Interval) = [-0.19, -0.01]) in the adjusted model. This association held in the age-stratified analyses. Associations for FLFP and lower male suicide-rates were observed in the ≥45 age-groups. FLFP rates were significantly and positively associated with widening male-to-female suicide-rates ratios in the adjusted model (ß = 0.24, 95% CI = [0.03, 0.59]).

Conclusion: This study's findings suggest that FLFP protects women from suicide, and point to the potential value of FLFP as a way of preventing suicide. In Taiwan, employed women carry a double-load of paid and family unpaid care-work. Child care-work is still done by mothers, often with grandmothers' support. Therefore, this study's findings contribute to evidence that doing both paid work and unpaid family care-work has more benefits than costs, including in terms of suicide-protection. Men's disengagement from family care-work may contribute to their high suicide rates, despite their substantial labor-force participation.

Objective: Individuals with recent nonsuicidal self-injury (NSSI) are at elevated risk for suicide but our understanding of the factors that impact the emergence of suicidal ideation and/or suicide attempts in this group is limited. The current study aimed to evaluate whether the processes identified by existing ideation-to-action theories of suicide apply within this subgroup.

Method: A sample of 362 university students (77.9% female, 88.5% White) who reported past year engagement in NSSI completed an anonymous online questionnaire assessing past year NSSI, suicidal ideation, and suicide attempts as well as hopelessness, interpersonal, and acquired capability/volitional variables. Participants were divided into NSSI only (controls), NSSI + Ideation, and NSSI + Suicide Attempt groups.

Results: A one-way ANOVA evaluated group differences on the theoretical factors. There were significant differences between NSSI controls and both the ideation and attempt groups, who did not differ from each other, on hopelessness and interpersonal factors. No significant differences were observed across groups for the volitional factors except for impulsivity, which differed between the NSSI controls and ideation group.

Conclusion: Results suggest suicide ideation-to-action theories may have applicability to understanding the presence of suicide ideation among those with NSSI but may lack specificity for understanding risk for suicide attempts.

Background: Suicide is a significant but understudied public health concern in developing nations like Pakistan, where risks factors have not been investigated by mixed methods studies. Hence, we aimed to explore the risk factors for suicide based on a mixed methodology.

Methods: This study followed a mixed methods convergent component design. A retrospective case-control psychological autopsy with a semistructured interview protocol was performed. Additionally, health professionals' opinions on the psychiatric risk factors for suicide were assessed through qualitative interviews. Data were collected between 2021 and 2022 and analyzed by SPSS (V-25) and thematic analysis (NVIVO-12 Plus).

Results: Based on the mixed methods meta-inferences, suicidal ideation; depression; hopelessness; social isolation; previous history of self-harm and traumatic experiences; lack of motivation; purposelessness; feeling like a burden; substance abuse; impulsivity; anger; anxiety; psychiatric disorders such as personality disorders, bipolar disorder, schizophrenia, gaming addiction, and eating disorders; and family history of psychiatric illness were identified as risk factors for suicide.

Conclusion: More must be learned about the mental health components contributing to suicide and the culturally appropriate prevention methods used in Pakistan. This study reveals novel targets for suicide prevention and may aid policymaking by providing a better understanding of predictors and specific psychiatric characteristics of suicide in Pakistan.

This study utilized latent class analysis to identify latent groups of individuals, reflecting the expanded dimensions of suicidality, which encompass not only one's own suicidality but also that of significant others. Drawing on data from Wave 3 and Wave 5 of the National Longitudinal Study of Adolescent to Adult Health, the analysis included 3215 individuals. The LCA revealed three distinct latent classes: the Exposed, the Suicidal, and the Non-Suicidal and Unexposed. Subsequent analysis using the Kruskal-Wallis test found significant longitudinal differences in mental health outcomes, including depression and suicidality, among these three latent classes over a 15-year period. Specifically, the Suicidal Class scored significantly higher than the Exposed Class and the Non-Suicidal and Unexposed Class for both depression and suicidality. Additionally, the Exposed Class scored significantly higher than the Non-Suicidal and Unexposed Class. These findings have implications for mental health researchers and practitioners, including the implementation of preventive and postventive interventions in the early stages, as well as the engagement of individual, family, and community partnerships in these interventions.

Objective: Guided by Minority Stress and Interpersonal and Ideation-to-Action Theories of Suicide, we sought to identify latent classes of painful and provocative events (PPEs), determine associations with class membership, and assess class-specific suicide attempt prevalence among cisgender sexually minoritized men (SMM) with suicidal ideation in the United States.

Method: Using data collected from October 2020 to January 2021 from 1617 SMM reporting past-year suicidal ideation, we performed latent class analysis on 22 PPE items spanning sexual behavior stigma, substance use, high-risk sex, and food and housing insecurity. We used multinomial logistic regression to assess associations with class membership and the Bolck-Croon-Hagenaars method to estimate class-specific past-year suicide attempt prevalence.

Results: Participant mean age was 29 years, 63% (n = 1010) were non-Hispanic white, and 14% (n = 221) reported a past-year suicide attempt. Five classes emerged: Extreme (7%, n = 113), featuring pervasive stigma, polysubstance use, high-risk sex, and food and housing insecurity; Severe/marijuana (15%, n = 236), featuring pervasive stigma, alcohol use, marijuana use, high-risk sex, and food insecurity; Severe (18%, n = 296), featuring the same PPEs minus marijuana use; Moderate (17%, n = 267), featuring family stigma, verbal harassment, some polysubstance use, and high-risk sex; and Mild (44%, n = 705), featuring family and friends stigma, verbal harassment, and alcohol use. Significantly higher suicide attempt prevalence emerged in the Extreme/Severe classes (12-16%) relative to the Mild/Moderate classes (2%).

Conclusions: Stigma and substance use were common across classes, implicating both as key factors shaping suicide risk among SMM. Holistic, multipronged, tailored interventions targeting stigma, substance use, and other PPEs are needed.

Objective: The Suicide Crisis Syndrome (SCS) has accumulated support as an indicator of suicide risk in patient settings; however, it has not been evaluated in military/veteran populations. The present study tested the factorial structure, measurement invariance, latent mean differences, and incremental validity of a SCS proxy variable developed from the Military Suicide Research Consortium's (MSRC) Common Data Elements (CDE).

Method: A secondary data analysis of 6,556 adults (40.5% current service members, 27.0% veterans, 26.6% civilians) who participated in MSRC-funded studies was conducted. CDE items were selected to form a SCS proxy, which was tested in subsequent analyses.

Results: A bifactor model exhibited superior model fit to alternative configurations. This model was partially invariant across those with differing histories of suicide and military service. Individuals with a history of suicidal ideation or attempts had more severe SCS symptoms than those without such history, and the SCS factor was incrementally related to lifetime suicide attempts and their characteristics above other relevant factors.

Conclusions: These findings provide evidence for the generalizability of the SCS to military service member and veteran populations, as well as the potential utility of proxy measures as an assessment tool in settings in which lengthy measures may be prohibitive.

Objective: Suicide prevention professionals and programs have focused on reaching not only individuals with suicide ideation, but also family, friends, and other acquaintances, referred to as suicide gatekeepers. Social media provide platforms that allow health communicators to reach a large population. This research focuses on examining and testing the most effective message framing (how the message provides a reward or consequence for the receiver) and message construct (precise focus and wording of a message) for social media posts intended to positively influence suicide gatekeeper intervention behavior on behalf of a friend or peer.

Method: An experiment tested the influence of message construct (between subjects) and message frame (within subjects). The experiment randomized the 1285 participants between the ages of 18 and 34 into the three message construct conditions (significance, preventability, and beneficence).

Results: The results suggest gain-framed messages have a more positive influence than loss-framed messages on all social media message outcome variables (likelihood of social media message engagement, perceived message effectiveness, self-efficacy, response efficacy, empathy, and behavioral expectation), and state empathy mediates the relationship between message frame and these variables. Message construct condition and other mediation results were less substantial, although some evidence suggests that the significance message construct may increase social media message sharing and perceived message effectiveness.

Conclusion: Results show strong evidence of the effectiveness of using gain frames in social media messages aimed at suicide gatekeepers. Other considerations include highlighting the significance of suicide and utilizing empathy appeals to strengthen social media message engagement and behavioral intention.

Introduction: Police records are an important resource in absence of a national suicide database in the context of Pakistan. We studied suicides reported across three districts of Gilgit-Baltistan (GB); causes, patterns of suicidal behaviors, and classification processes.

Methods: A retrospective survey of police records from GB between 2012 and March 2022 was completed using a structured questionnaire that included demographic characteristics, possible causes, and forensic details. Descriptive statistics and a chi-square test of association were applied. This study was approved by the Institutional Review Board of Shifa International Hospital, Islamabad (IRB 0210-22).

Results: In total, 340 cases of suicides were registered. Among them, 53% (n = 179) were females, 59% (n = 202) unmarried and 40% (n = 136) below 20 years of age. Stress and mental illnesses were reported in 73% (n = 247) cases. Common methods of suicide were hanging (41%; n = 141) and firearms (25%; n = 85). More men compared to women attempted suicide by firearms while more women died by drowning or poisoning. Greater proportion of individuals who were unmarried and had formal education died by suicide compared to their demographic counterparts. Number of individuals having a "mental illness" was higher in men while significantly more women were affected by "domestic stressors." Seven (2.9%) cases reported between 2021 and 2022 were reclassified as homicides.

Conclusion: Suicide is more common among females compared to males, unmarried compared to married, and younger population compared to older population. Cases reclassified as homicide highlight the need for rigorous forensic inquiry of each suicide. Development of effective suicide prevention strategies is urgently required.

Objective: Sexual and gender minority adolescents face elevated rates of self-injurious thoughts and behaviors (SITBs) relative to peers, yet fewer studies have examined risk in these youth, and reasons for higher risk remain unclear. Modeling SITBs using traditional statistical models has proven challenging. More complex machine learning approaches may offer better performance and insights. We explored and compared multiple machine learning models of suicide ideation, suicide attempts, and non-suicidal self-injury-both past-year frequency and dichotomous lifetime occurrence-among adolescents of diverse gender identities and sexual orientations.

Method: Data came from a large adolescent survey (N = 2,452) including psychological and demographic features. We compared prediction performance between generalized linear models, random forest models, and gradient boosting decision tree models using the full sample.

Results: Contrary to hypotheses, we found that these models generally performed comparably. We then selected the best-performing model families to run follow-up comparisons between cisgender and gender minority adolescents and between heterosexual and sexual minority adolescents. Depression was consistently the top-ranked feature across all models save one, in which discrimination was the top-ranked feature for lifetime occurrence of suicide attempt in the gender minority group. In addition, loneliness was more important in the gender minority group relative to the cisgender group for models of suicidal ideation.

Conclusion: Discrimination and loneliness emerged as important features in predicting SITBs amongst gender minorities. Future work should examine these factors both as possible statistical predictors of SITB risk and as treatment targets for gender minority youth.